Clin Transplant. 2021 Jun 8. doi: 10.1111/ctr.14382. Online ahead of print.
ABSTRACT
PURPOSE: The risks and benefits of remote corticosteroid weaning in heart transplant recipients more than two years post-transplant are unknown. We compared outcomes in patients undergoing early and remote steroid weaning after heart transplantation.
METHODS: We performed a retrospective study (range 09/1991- 04/2017). Primary outcomes included short-term and long-term mortality, allograft dysfunction and burden of rejection. Secondary outcomes included impact on hemoglobin A1c, lipid panel, bone scan Tscore, and body mass index.
RESULTS: 63 patients underwent corticosteroid weaning between 2012 and 2017. Outcomes of patients weaned early (n = 34; median time from transplant = 1.1 years) were compared with those weaned late (n = 29; median time from transplant = 4.4 years). 52 (82.5%) patients were successfully weaned off corticosteroids. No statistically significant difference in outcomes was found between the early and late weaning groups (p = 0.20). There were no differences in allograft function (p-value = 0.16), incidence of rejection (p = 0.46) or mortality (p = 0.15). Improvement in metabolic profile was seen in both groups but was not statistically significant.
CONCLUSIONS: In heart transplant recipients remote vs early weaning of corticosteroids is not associated with significant differences in graft function or the incidence of rejection after one-year follow-up. Moreover, there were no significant differences in survival up to three years between the two groups. This article is protected by copyright. All rights reserved.
PMID:34101911 | DOI:10.1111/ctr.14382
